Reacción a "A study suggests that stopping statin treatment in people aged 75 and over with no history of heart disease or stroke does not increase the risk of death"

This study looked at whether stopping treatment with a statin in people over the age of 75 years affects the risk of dying over the subsequent 3 years. Although the study found no significant effect of stopping a statin on mortality risk, there are many limitations to the study and it should not be used to inform decision-making in the majority of people treated with a statin in this age group. 

Firstly, the study was too small and follow-up was too short to get a clear idea of the benefits of statin treatment. Studies looking at any benefits of cholesterol treatment on life expectancy need to include many thousands of people whereas this study only included just over one thousand people and there were only 521 people in the group that were asked to stop their statin, with only 388 of these actually completing 3 years of follow-up. 

Secondly, statins tend to have more impact on the risk of heart attack than the risk of dying overall. In this study, heart attack occurred in 1.4% of those who continued their statin compared with 2.1% of those who stopped their statin. Even though the study was not large enough to get a very accurate idea of the actual risk of heart attack, these data should at least raise a note of caution about stopping statins.

Thirdly, even though the study included people over the age of 75 years, more than half of the study participants were over the age of 80 years and therefore had a high risk of dying from conditions other than cardiovascular disease.

Fourthly, the study authors clearly point out that stopping a statin did not lead to an improvement in quality of life or reduction in symptoms that might be considered side-effects of statins so there was no evidence of a detrimental effect of continuing treatment with a statin. 

Finally, the study struggled to recruit participants, presumably since many of the people approached were not happy with the concept of stopping a beneficial treatment just on the basis of their age, and this means that the people included may not be well representative of the over-75s consulting their doctors about the need for continued statin treatment.

Overall the circumstances in which these study results will help with decision-making are very limited and there is a risk that it will promote stopping of statins in  people over 75 who may otherwise benefit from reduced heart attack risk.